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Homocysteine (cont.)

Who Should Have Their Homocysteine Levels Tested?

Infants blood and urine are often checked for elevated homocysteine levels if they have a family history of the disease, or if they have certain medical conditions including eye lens dislocations, unusual (Marfan type) body shape, mental retardation, or signs of stroke.

Younger adults who have an early heart attack, stroke, or blood clots are often screened for blood clotting abnormalities including homocysteine blood tests.

Homocysteine levels are also often measured when a patient suffers a heart attack or stroke and has no risk factors for that illness (smoking, high blood pressure, high cholesterol, diabetes).

At present it is not recommended that individuals consuming normal diets with adequate folate levels be screened for elevated homocysteine levels.

Can Lowering Homocysteine Levels Prevent the Risk of Heart Disease, Heart Attacks, and Strokes?

There is controversy whether lowering homocysteine levels affects the risk of vascular disease like heart attack and stroke. At present there is no proof to show that lowering these levels has any benefit in terms of disease prevention, so treatment aimed at lowering blood homocysteine levels is not recommended for most people who do not have severe hyperhomocysteinemia. Some studies suggest that lowering homocysteine levels may decrease the risk of stroke. However, while the overall risk of stroke decreased in these studies, the severity of the stroke and the amount of disability were not affected. More importantly, medications that affect platelet function such as aspirin, clopidogrel (Plavix), and aspirin-dipyridamole (Aggrenox) are recommended and are effective as secondary stroke prevention medications. There is uncertainty whether the risk of heart disease is affected.


Haque WM. Homocysteine and Pregnancy. Best Pract Res Clin Obstet Gynaecol. 2003 Jun;17(3):459-69

Saposnik G; Ray JG; Sheridan P; McQueen M; Lonn E. Homocysteine-lowering therapy and stroke risk, severity, and disability: additional findings from the HOPE 2 trial. Stroke. 2009; 40(4):1365-72

Medically Reviewed by a Doctor on 9/11/2017

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Homocysteine - Prevention of Heart Disease

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